Natural Killer (NK) Cell Assay for the Consumer
This is a very precise and simple test that is done by a sophisticated machine called a flow cytometer. Twelve percent of women with recurrent pregnancy losses (3 or more) and 35% of women with 3 or more IVF failures have elevations in NK cells. Natural killer (NK) cells are one of the oldest lymphocytes (white blood cells) in man. They have many functions. One of these functions is to produce a cytotoxic chemical called tumor necrosis factor (TNF). This is a chemotherapy drug that kills cancer cells in our body. In some couples, the embryo is misinterpreted as a cancer cell and when pregnancy is initiated, the Natural Killer cells of the woman increase in numbers and in killing power. Subsequent pregnancies fail early because of this activation. The embryo is damaged just as a cancer cell, by the tumor necrosis factor. This activation of Natural Killer cells has adverse consequences in some women.
Five percent of women with activate NK cells may develop thyroiditis. This may result in an overactive or an underactive thyroid condition (hyper or hypothyroidism - inflammation of the thyroid gland resulting in over or under production of thyroid hormone). A blood test in these women shows that they have developed antibodies to thyroid microsomes, thyroglobulin or peroxidase and which results in a diagnosis of Hashimoto's thyroiditis. It is recommended that women with activated natural killer cells have a thyroid evaluation yearly to make certain that this condition is not developing.
The test for NK cell activity is a simple one. Natural Killer cells from the woman are separated from her blood and are cultured at different dilutions with target cells that they can kill. The target cells used are from an embryonic cancer cell line that have many similarities to placentas and embryos. These target cells are tagged with a special cytoplasmic dye so that the flow cytometer can find them when asked to see how many of the targets have been killed by the NK cells that have been placed in culture with them. After two to four hours of culturing the NK cells with the embryo-like targets, a special DNA dye called propidium iodide is added to the culture. This dye is taken up by the DNA of the cells that have been killed. The living cells do not take up the dye. The cell suspensions are then put into the flow cytometer and it precisely counts the percentage of dead to live cells at the different dilutions.
How to Get the Test 
Our registered patients may obtain this test by following the steps below:
- The test must be scheduled with Chris Sanow at (408) 356-9500 or by e-mail at csanow@repro-med.net.
- Our physicians will interpret this test.
- The blood is shipped at room temperature by overnight mail and must arrive Monday - Thursday. No blood is received on Friday or the Weekend since the test must be done immediately on fresh blood.
- The test results are available to the patient 72 hours after receipt of the blood.
- The couple must give a working telephone number, FAX or e-mail address for immediate communication at the time the test results are available.
- Four (4) 10 cc Green Topped Tubes (heparin) are required from the woman. Blood drawing and shipping instructions are faxed, e-mailed or called into the laboratory or doctor's office selected to do the drawing. Some laboratories will not draw or ship blood unless their laboratory is doing the test. Couples should inquire about this prior to scheduling since the blood drawn must be air expressed to the laboratory in Chicago.
- The insurance codes and the cost of the test will be given to the patient when scheduling is done. These codes can be presented to the insurance provider pre testing to determine benefits.
Please check out the A Guide to Interpreting the Results of the Reproductive Immunophenotype for more information.
References
Gilman-Sachs A, DuChateau BK, Aslakson CJ, Wohlgemuth GP, Kwak JY, Beer AE, Beaman KD. Natural killer (NK) cell subsets and NK cell cytotoxicity in women with histories of recurrent spontaneous abortions. Am J Reprod Immunol. 1999 Jan;41(1):99-105.
The information contained in this article is not intended to be a medical diagnosis, treatment or medical advice in any way, as it is general information and cannot be relied on without consultation with your physician. It is not intended nor is it implied to be a substitute for profession medical advice. As medical information can change rapidly, we strongly encourage you to discuss all health matters and concerns with your physician before embarking on new diagnostic or treatment strategies.
Alan E. Beer Center for Reproductive Immunology & Genetics
15151 National Ave. #2; Los Gatos, CA 95032; Phone: (408) 356-9500; Fax: (408) 356-9509; E-mail: info@repro-med.net.
Date: 8-20-08, Time: 1:17 am.
General Question? E-mail: info@repro-med.net.
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